Provider First Line Business Practice Location Address:
1619 FRANKLIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUBA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95993-4609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-490-8337
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2019